Individual
AMANDA NEZAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 TOBY TRL, HUTTO, TX 78634-5249
(512) 642-4076
Mailing address
12201A TYSON CV, DUPLEX A, AUSTIN, TX 78758-5310
(512) 644-6926
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
58240102769
TX
171M00000X
Case Manager/Care Coordinator
Primary
58240102769
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104216001
—
TX
Enumeration date
01/29/2015
Last updated
02/12/2015
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